Introduction Worcestershire Acute Hospitals NHS Trust currently have an Alcohol Liaison Nurse (ALN) Service. In response to NICE and Making Every Contact Count we wanted to implement a lifestyle screening tool within the out patients clinic, and be able to offer signposting and an opportunistic Brief Intervention (BI) service.
Methods Patients aged over 16 years attending a busy gastroenterology out-patients clinic were asked to complete a ‘lifestyle’ screening tool using the AUDIT-C (Babor 2001) to assess alcohol use and smoking status.
Individuals identified as smokers, were advised of the health risk by the a specially trained health care assistant and signposted to a smoking cessation service.
Individuals who were AUDIT-C positive (>5) were referred by the consultant to the Alcohol Liaison Nurse (ALN) for further assessment and Brief Intervention.
Results 448 patients attended the clinic. 60% (n = 269) were asked to complete the tool (2 refused).
32 (12%) individuals were identified as smokers. 13 males with a median age of 56 and 19 females with a median age of 49. 18 accepted an advice card.
82 (31%) AUDIT-C >5. 46 males with a median age of 53 and 36 females with a median age of 51. 27 accepted referral to ALN (3 unable to contact).
The highest reported motivating factors for change were improved physical and mental health, followed by better finances and weight loss. 75% of the sub-group receiving Brief Intervention could not identify any costs of change. The sub-group also scored high in relation to readiness to change and confidence to change following the BI. Extended BI reported reduced AUDIT-C scores and reduced drinking days/unit consumption.
Conclusion The results suggests that lifestyle screening is a achievable and acceptable in a busy gastroenterology clinic. A significant proportion of patients attending a gastroenterology clinic are likely to be using alcohol at harmful levels or smoking and are therefore likely to benefit from opportunistic BI or signposting to smoking cessation services.
Babor T, Higgins-Biddle J, Saunders J, Monteiro M. The Alcohol Use Disorders Identification Test. Guidelines for use in primary care. 2nd ed. Geneva, Switzerland: WHO 2001
The NHS’s role in the public’s health: A report from the NHS Future Forum. Accessed online [04/12/2013] https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/216423/dh_132114.pdf
Disclosure of Interest None Declared.
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